Condition
Acute Kidney Injury
Acute kidney injury is a sudden drop in kidney function over hours to days, often after reduced blood flow, direct kidney damage, or a urinary blockage. Vitamin E has moderate evidence, with fewer cases of kidney injury reported, and among people in shock, angiotensin II was linked to more coming off dialysis and surviving 28 days. That angiotensin II result came from a follow-up analysis still needing confirmation.
Sources: PMID 29925534
- Supplements studied
- 6
- Medicines and peptides
- 1
- Graded outcomes
- 7
- People studied
- 580
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Hyperphosphatemia Management in CKD Multiple human clinical studies in CKD and dialysis patients demonstrate that dietary phosphorus restriction and modified cooking methods effectively reduce serum phosphorus levels. Improving diet recipes and cooking methods attenuated hyperphosphatemia in peritoneal dialysis patients. Very low protein diets supplemented with keto-analogues also reduced phosphorus burden. | Improves (the measure goes up) | Moderate effect | 5 studies | |||
Studies that measured hyperphosphatemia management in ckd | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acute Kidney Injury Incidence Moderate Improvement | Improves (the measure goes down) | Moderate effect | 357 people | |||
| Creatinine | Improves (the measure goes up) | 1 study | 478 people | |||
Studies that measured creatinine | ||||||
| Kidney Function | Improves (the measure goes up) | 425 people | ||||
Valine
- Plasma BCAA Levels in Renal Insufficiency: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Plasma BCAA Levels in Renal Insufficiency Studies in patients with chronic renal insufficiency show altered BCAA metabolism including valine. A randomized crossover study found BCAA-enriched dialysis fluid improved plasma BCAA concentrations. Keto acid-amino acid supplements influenced BCAA metabolism in CKD patients on low-protein diets. | Improves (the measure goes up) | Small effect | 5 studies | 40 people | ||
Studies that measured plasma bcaa levels in renal insufficiency | ||||||
Chaga
- Kidney Damage Risk (Oxalate Nephropathy): worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Kidney Damage Risk (Oxalate Nephropathy) A case report documented chaga mushroom-induced oxalate nephropathy presenting as nephrotic syndrome. Chaga contains high levels of oxalates, and excessive consumption may cause kidney injury. This is an adverse effect warranting caution. | Worsens (the measure goes up) | Moderate effect | 3 studies | 1 person | ||
Studies that measured kidney damage risk (oxalate nephropathy) | ||||||
East Indian globe thistle
- Nephroprotection (Drug-Induced Kidney Injury): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Nephroprotection (Drug-Induced Kidney Injury) In a rat model of cisplatin-induced nephrotoxicity, ethanol extract of S. indicus (150 and 300 mg/kg) significantly reduced elevated serum creatinine and urea levels, restored renal antioxidant enzymes (SOD, catalase, GPx, GSH), and reduced lipid peroxidation. Effects attributed to the plant's antioxidant potential. | Improves (the measure goes down) | Moderate effect | 3 studies | |||
Studies that measured nephroprotection (drug-induced kidney injury) | ||||||
Danshen
- Kidney Injury Risk: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Kidney Injury Risk In a rat model, tanshinone IIA attenuated contrast-induced nephropathy via Nrf2 antioxidant pathway activation (PMID:29763899). A network pharmacology study with experimental validation explored mechanisms of the danshen-containing formula Shenkang in chronic kidney disease (PMID:31386888). Human clinical data for renal protection is absent. | Improves (the measure goes down) | Small effect | 2 studies | |||
Prescription medicines and peptides studied, for context
Angiotensin II
- Renal Recovery in AKI: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Renal Recovery in AKI Post-hoc ATHOS-3 (n=105): Higher RRT liberation rate and 28-day survival (53% vs 30%, P=0.012) in AKI patients. May preferentially benefit those with renal failure. Requires prospective validation. | Improves (the measure goes up) | Moderate effect | 50 studies |
Key findings
- Hyperphosphatemia Management in CKDImproves (the measure goes up)
- Acute Kidney Injury IncidenceImproves (the measure goes down)
- Plasma BCAA Levels in Renal InsufficiencyImproves (the measure goes up)
Safety notes in the studies
- This is an adverse effect warranting caution.
The Acute Kidney Injury Recovery Support protocol
2 primary supplements · 5 supporting supplements
- Vitamin E400–800 IU daily (mixed tocopherols)
- N-Acetyl Cysteine (NAC)600–1,200 mg twice daily (especially around contrast exposure)
Studies cited
100 studies from PubMed
- Phytochemical and nanoparticle-based therapeutic potential of Sphaeranthus indicus against hepatocellular carcinoma via cryptomeridiol targeting
- Hyperphosphatemia
- Angiotensin-II and Thromboembolic Events: A Systematic Review
- Angiotensin II Is Involved in MLKL Activation During the Development of Heart Failure Following Myocardial Infarction in Rats.
- The Role of Local Angiotensin II/Angiotensin Type 1-receptor Mechanisms in Adipose Tissue Dysfunction to Promote Pancreatic Cancer.
- Chemical Content and Cytotoxic Activity on Various Cancer Cell Lines of Chaga (Inonotus obliquus) Growing on Betula pendula and Betula pubescens.
- Antidiabetic activity of Inonotus obliquus water extract in alloxan-induced diabetic mice.
- Therapeutic Potential of Salvia miltiorrhiza Root Extract in Alleviating Cold-Induced Immunosuppression
- A botanical extract blend of Mangifera indica and Sphaeranthus indicus combined with resistance exercise training improves muscle strength and endurance over exercise alone in young men: a randomized, blinded, placebo-controlled trial
- Comparison of Bioactive Secondary Metabolites and Cytotoxicity of Extracts from Inonotus obliquus Isolates from Different Host Species.
- A proprietary blend of Sphaeranthus indicus flower head and Mangifera indica bark extracts increases muscle strength and enhances endurance in young male volunteers: a randomized, double-blinded, placebo-controlled trial
- Roles of autophagy in angiotensin II-induced cardiomyocyte apoptosis.
- Triterpenoids as bivalent and dual inhibitors of acetylcholinesterase/butyrylcholinesterase from the fruiting bodies of Inonotus obliquus.
- Chaga mushroom-induced oxalate nephropathy that clinically manifested as nephrotic syndrome: A case report.
- Tanshinone I inhibits metastasis of cervical cancer cells by inducing BNIP3/NIX-mediated mitophagy and reprogramming mitochondrial metabolism
- Salvia miltiorrhiza in cancer: Potential role in regulating MicroRNAs and epigenetic enzymes
- Comparison of Polysaccharides Extracted from Cultivated Mycelium of Inonotus obliquus with Polysaccharide Fractions Obtained from Sterile Conk (Chaga) and Birch Heart Rot.
- Phosphate Metabolism in Health and Disease
- Prediction of the mechanisms of action of Shenkang in chronic kidney disease: A network pharmacology study and experimental validation
- Phosphate disorders and clinical management of hypophosphatemia and hyperphosphatemia
- Regulation of Skeletal Muscle Function by Amino Acids.
- Short-Term Effects of Branched-Chain Amino Acids-Enriched Dialysis Fluid on Branched-Chain Amino Acids Plasma Level and Mass Balance: A Randomized Cross-Over Study.
- Branched-Chain Amino Acid Catabolism Promotes Thrombosis Risk by Enhancing Tropomodulin-3 Propionylation in Platelets.
- A Novel Dietary Intervention Reduces Circulatory Branched-Chain Amino Acids by 50%: A Pilot Study of Relevance for Obesity and Diabetes.
- Branched chain amino acids improve mesenchymal stem cell proliferation, reducing nuclear factor kappa B expression and modulating some inflammatory properties.
- Angiotensin II (Giapreza): A Distinct Mechanism for the Treatment of Vasodilatory Shock
- FDA Approval of Angiotensin II for the Treatment of Hypotension in Adults with Distributive Shock
- Association Between Early Response to Angiotensin-II and Mortality in Septic Shock: A Post Hoc Analysis of the ATHOS-III Clinical Trial
- Renin-Angiotensin System in the Intensive Care Unit
- Simultaneous Use of Stimulatory Agents to Enhance the Production and Hypoglycaemic Activity of Polysaccharides from Inonotus obliquus by Submerged Fermentation.
- Impact of the Chinese herbal medicines on dual antiplatelet therapy with clopidogrel and aspirin: Pharmacokinetics and pharmacodynamics outcomes and related mechanisms in rats
- 7-hydroxyfrullanolide, isolated from Sphaeranthus indicus, inhibits colorectal cancer cell growth by p53-dependent and -independent mechanism
- Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II
- Angiotensin II: a new therapeutic option for vasodilatory shock
- Angiotensin II Brings More Questions Than Answers
- Angiotensin II and Treatment of High-Output Shock in Human Beings: A Matched Case Series
- Vasodilatory shock in the ICU and the role of angiotensin II.
- Chaga (Inonotus obliquus), a Future Potential Medicinal Fungus in Oncology? A Chemical Study and a Comparison of the Cytotoxicity Against Human Lung Adenocarcinoma Cells (A549) and Human Bronchial Epithelial Cells (BEAS-2B).
- Tanshinone IIA Attenuates Contrast-Induced Nephropathy via Nrf2 Activation in Rats
- Vitamin D and kidney disease
- Branched-chain amino acids promote endothelial dysfunction through increased reactive oxygen species generation and inflammation.
- Diabetes and branched-chain amino acids: What is the link?
- Branched-chain amino acids in health and disease: metabolism, alterations in blood plasma, and as supplements.
- Branched Chain Amino Acids: Beyond Nutrition Metabolism.
- Angiotensin II for the Treatment of Vasodilatory Shock
- Angiotensin II type 1a receptor-deficient mice develop angiotensin II-induced oxidative stress and DNA damage without blood pressure increase.
- Angiotensin II and skeletal muscle abnormalities.
- Secondary Hyperparathyroidism: Pathogenesis, Diagnosis, Preventive and Therapeutic Strategies
- Plant phosphates, phytate and pathological calcifications in chronic kidney disease
- Branched-Chain Amino Acids and Brain Metabolism.
- Phosphate-a poison for humans?
- Very low protein diets supplemented with keto-analogues in ESRD predialysis patients and its effect on vascular stiffness and AVF Maturation
- Inonotus obliquus - from folk medicine to clinical use
- Antiviral activity of aqueous extracts of the birch fungus Inonotus obliquus on the human immunodeficiency virus.
- Phosphorus: a new cardiovascular risk factor?
- Improving diet recipe and cooking methods attenuates hyperphosphatemia in patients undergoing peritoneal dialysis
- Oxalate nephropathy from excessive Chaga mushroom consumption
- Salvia miltiorrhiza: an ancient Chinese herbal medicine as a source for anti-osteoporotic drugs
- Sphaeranthus indicus (East Indian Globe Thistle) - A promising natural remedy for psoriasis
- Canaries in the Phosphate-Toxicity Coal Mines
- Anti-oxidant and anti-inflammatory activities of Inonotus obliquus and germinated brown rice extracts.
- Tanshinone IIA exhibits anticonvulsant activity in zebrafish and mouse seizure models
- Sphaeranthus indicus induces apoptosis through mitochondrial-dependent pathway in HL-60 cells and exerts cytotoxic potential on several human cancer cell lines
- Insulin resistance and the metabolism of branched-chain amino acids.
- Branched-chain amino acids influence the immune properties of microglial cells and their responsiveness to pro-inflammatory signals.
- Effect of Sphaeranthus indicus on cisplatin-induced nephrotoxicity in rats
- Effect of ethanol extract of Sphaeranthus indicus on cisplatin-induced nephrotoxicity in rats
- Phosphate control in peritoneal dialysis
- Antiviral activity of Inonotus obliquus fungus extract towards infection caused by hepatitis C virus in cell cultures.
- Sphaeranthus indicus attenuates testosterone induced prostatic hypertrophy in albino rats
- Branched-chain amino acids as pharmacological nutrients in chronic liver disease.
- Angiotensin (1-7) receptor antagonism equalizes angiotensin II-induced hypertension in male and female spontaneously hypertensive rats.
- Antitumor activity of water extract of Inonotus obliquus
- Sphaeranthus indicus Linn.: A phytopharmacological review
- Phosphate and carbonate salts of calcium support robust bone building in osteoporosis
- Antioxidant and antitumor activities of Chaga extract (Inonotus obliquus)
- Effect of point injection of red-sage-root on the hip joint function in ischemic femoral head necrosis patients
- Mast cell stabilizing effects of Sphaeranthus indicus
- Identification of Inonotus obliquus and analysis of antioxidation and antitumor activities of polysaccharides.
- The skeleton: endocrine regulator of phosphate homeostasis
- Angiotensin II-nitric oxide interaction in the kidney.
- Angiotensin II type 2 receptor decreases ischemia reperfusion induced fluid leak.
- Cytotoxic activity of Sphaeranthus indicus extracts and 7-hydroxyfrullanolide
- Application of branched-chain amino acids in human pathological states: renal failure.
- Branched-chain amino acids: enzyme and substrate regulation.
- Angiotensin II and renal tubular ion transport.
- Angiotensin II, angiotensin II antagonists and spironolactone and their modulation of cardiac repolarization.
- Angiotensin-II behaves as an endogenous pro-inflammatory molecule.
- Protective effects of angiotensin II interruption: evidence for antiinflammatory actions.
- Immunomodulatory activity of the water extract from medicinal mushroom Inonotus obliquus
- Effect of magnesium lithospermate B on endothelial cells in human aorta after free radical injury
- Phosphorus nutrition and the treatment of osteoporosis
- Cardiac angiotensin II: an intracrine hormone?
- Angiotensin II as a mediator of renal tubular transport.
- Angiotensin II induces phenotype-dependent apoptosis in vascular smooth muscle cells.
- Primary Disorders of Phosphate Metabolism
- Effect of a keto acid-amino acid supplement on the metabolism and renal elimination of branched-chain amino acids in patients with chronic renal insufficiency on a low protein diet.
- Angiotensin II receptor blockers: review of the binding characteristics.
- Attenuation of the protein wasting associated with bed rest by branched-chain amino acids.
- Angiotensin II receptors in the kidney.